The internet's only blog on Health Insurance

April 29, 2008

California voters feel let down on health care plan

Just a few months after the governor's state health-reform proposal collapsed, it appears California voters liked his idea by a landslide. And now they're feeling more insecure and pessimistic than ever about the future of medical coverage.
That's the gist of a new survey released today by the non-partisan Field Poll and paid for by the private California Wellness Foundation.

A whopping 72 percent of voters interviewed by pollsters said they generally favored Gov. Arnold Schwarzenegger's plan, even as they had some concerns about the funding scheme.

"The governor and the Legislature were clearly on the right path," pollster Mark DiCamillo said. "They had the support of the public."

But Sacramento politicians also faced a budget shortfall roughly equal to the $14.7 billion cost of the health-care bill. The proposal died in the state Senate's health committee, winning only one vote from a Democrat.

"It was a bad circumstance of timing," DiCamillo said. "The budget was under pressure from every quarter to just maintain."

Still, some supporters of the bill feel vindicated today.

"This was absolutely a blown opportunity," said Elia Gallardo, government affairs director for the California Primary Care Association. The organization lobbies for community clinics, which stood to gain about $140 million a year. She said one-fourth of the 4 million clinic patients don't have health insurance.

To those polled, the future of health reform looks bleak. Three times as many expect the health care system to get worse in five years as think it will improve - 39 to 13 percent. The Field Poll found the same sense of impending catastrophe in a similar survey in 2006. But in some specific categories, such as losing coverage completely, worries appear to be running higher today.

Like most surveys of this type, the Field Poll interviewed a small sample of voters, in this case 1,202, who more or less reflected the state's political and demographic diversity.

Jose Mora, a retired Democrat from Morgan Hill, supported the health insurance plan even though he didn't think its new fees, taxes and mandates would have covered the full cost.

April 24, 2008

Health insurance a matter of life and death: study

Whether or not a person has health insurance can mean life or death, according to “Dying for Coverage” a recent Families USA report for all 50 states and the District of Columbia. The report revealed the number of Americans expected to die in each state, each week because they don’t have health care coverage.

Families USA is a national non-profit that advocates for affordable, high quality health care.

Using data from a 2002 groundbreaking national federal study, Dying for Coverage demonstrated direct links between a lack of health coverage and deaths from health-related causes. It found more than 7 working-age Texans die each day due to a lack of health insurance. “Our report highlights how our inadequate system of health coverage condemns a great number of people to an early death, simply because they don’t have the same access to health care as their insured neighbors,” said Ron Pollack, executive director of Families USA.

“Health insurance really matters in how people make their health care decisions,” he continued “We know that people without insurance often forgo checkups, screenings and other preventive care.” The study was released April 8.

For Khalilah Ali, a Dallas based family nurse practitioner, the findings are no surprise. Her Supreme Wisdom Family Health Clinic specializes in serving the medically underserved. “People in Dallas that don’t have health insurance are usually referred to Parkland Hospital, the place where President John F. Kennedy died. They have very long waits and I believe receive substandard care. Health insurance makes the difference,” she said.

Mrs. Ali drives around Dallas making house calls like country doctors of days gone by. “There is an epidemic of high blood pressure and diabetes in the Black community. For many people even when they have medicine, they save it so they don’t run out. That can be deadly because their blood pressure is always high.

“Even the seniors who have Medicare which only pays 80 percent, many still can’t afford to buy their prescriptions. So they take half of their medicine, or cut the pills in half, or only take it when they have symptoms of their illness,” she said.

April 22, 2008

The Truth About Mandatory Health Insurance

Hillary Clinton's supporters attacked Barack Obama [in January] for not proposing a federal mandate that every American buy health insurance. Mr. Obama's health insurance plan, they said, is a "Band-Aid" for the nation's gaping wound: 47 million people without health insurance. Mrs. Clinton would require all Americans to get coverage. Presidential candidate John Edwards and Christopher Dodd say they would, too. Not Mr. Obama.

Imposing a federal mandate is a hot issue on the campaign trail. It's also a burning issue in Congress, where Democratic Sen. Ron Wyden and Republican Sen. Bob Bennett are pushing the Healthy Americans Act, which would require everyone not in Medicaid or another government program to get health insurance.

'Shared Responsibility'

But is mandatory health insurance really a good idea? Requiring catastrophic coverage (our parents called it major medical) probably is smart. This would ensure that a person who is hurt in a car accident or diagnosed with a costly illness can pay his own medical bills, instead of being a burden on society.

But catastrophic coverage is not what the mandate advocates want. They would require that everyone have comprehensive health insurance, covering preventive and routine care.

The rationale for this mandate is not personal responsibility but "shared responsibility," a polite way of saying shared costs. Requiring comprehensive coverage, the argument goes, will make it affordable for the sick, by pulling the young and the healthy--neither of whom use these health services very much--into the insurance pool. Advocates also argue that requiring this type of coverage will cure overcrowded emergency rooms and help tame skyrocketing health care costs.

Ehnes, whose department has investigated rescission practices at those plans since 2005, has scheduled a news conference for 1 p.m. PDT in Sacramento. California already has levied fines for rescissions against several health insurance plans that offer individual policies in the state. Last fall, the state fined Health Net $1 million for failing to disclose a link between employee bonuses and the cancellation of individual insurance policies.

The state's managed-care regulators aim to stop what they consider an illegal industry practice: rescinding individual health coverage, sometimes after members have become sick, based on inadvertent or insignificant omissions on enrollment applications.

Ehnes and California Insurance Commissioner Steve Poizner last year proposed joint regulations to protect consumers in the individual health-insurance market from illegal rescissions.

April 11, 2008

Insurance system of U.S. in shambles

One of the big issues for the upcoming presidential election in November is healthcare. Democrat candidates Barack Obama and Hillary Clinton, in some form or another, want to mandate that individuals be required to purchase healthcare coverage. Republican candidate John McCain wants to allow for tax breaks that would help cover the cost of insurance, but he has resisted any steps toward a mandatory requirement to purchase health insurance. But what happens when your health insurance provider decides to stop providing?

Patsy Bates, a California hairdresser, was diagnosed with breast cancer in 2003. She did have health insurance through Health Net, a for-profit health insurance provider in California. But, a few months into her cancer treatment, Health Net suddenly decided they were going to cancel her insurance policy.

“In fact, she was in the hospital getting prepped for surgery when she first learned Health Net was dropping her,” according to a Nov. 9, 2007, report by Bill Whitaker of CBS News. Bates, still in need of treatment, was stuck up the proverbial creek without the proverbial paddle. Bates was forced to quit her cancer treatment regimen until she found a charity to pay for it. She was also hung out to dry for $129,000, the cost of the treatments she received that Health Net refused to pay for.

So what happens when we’re all mandated to buy healthcare and then, when we get sick, our (for-profit) insurance provider drops us like a hot rock? Sounds like a big, fat, mandatory payday for the insurance companies, if you ask me! And, if you just happen to have any “pre-existing” conditions before you’re mandated to purchase health insurance, it’s an even bigger payday for the health insurance companies. Luckily, at least for Bates, in this case the good guys won.

April 08, 2008

Who’s Opposed to Informed Choices on Health Insurance by Californians?

I'm a good bargain shopper. (My prize: 10-piece set of top tier Calphalon pots once for $70) Here are my rules for assessing a good bargain:

1. Is it a known product (do I know it's a quality product -- like Calphalon)

2. If it's marked down, is it a good price compared to other similar products

3. Lastly, will I use it (because it does me no good to get a good deal on shoes if I'm not going to wear them...and I've done this way too much).

This mental checklist is meant to ensure that the product is of value to me.

Which brings me to the letters submitted by the health insurance industry SB 1522 (Steinberg), which create standards for health insurance that would enable any person to go through such a checklist when buying insurance on their own. (See our Fact Sheet on SB 1522.)

In short, SB1522 would:

1. Classify health plans into five "tiers'' so consumers would know what they were buying - i.e. a top tier plan means comprehensive, bottom tier means "catastrophic.'' (Known/quality product)

2. Insurers would have to have at least one plan in eacth tier, enabling apples-to-apples comparisons.

3. Establish minimum benefits, which would weed out junk insurance -- such as "hospital only'' plans that barely covers the hospital visit. (will I/can I use it?)

Let's step back a bit. Let's say you don't receive health insurance on the job now and have to go out and scavenge for a decent plan. Go to http://www.insuremyhealth.com/ and you'll get hit with 107 plans with all manner and range of co-pay, deductible, premium, office visit policies.

The "choice'' argument: Insurers argue that SB1522 will lead to a reduction in consumer choice. First off, their argument is bogus. Choice will still exist; it will just be more organized and limited. And limiting choice for consumers is actually a good thing, according to research on a parallel issue-401(k)s (the research on choice can also be applied to choosing ice cream, jams and insurance policies):

"...Findings from this study show that an extensive array of options can at first seem highly appealing to consumers, yet it can also reduce subsequent motivation to purchase this product...the very act of making a choice from an excessive number of options might result in "choice overload,'' in turn lessening both teh motivation to choose and the subsequent motivation to commit to a choice....''

That research correlates with private polling of uninsured and individual market participants, which also reveals that consumers do not have confidence in their understanding of what the insurance plans provide, nor do they trust the literature that is provided by the plans.

SB1522 would provide choice, but in an organized fashion so that consumers could go through their mental checklist and feel comfortable about a "known product'' and make comparisons against other plans.

April 03, 2008

Cautionary Health Care Tales

The collapse of health reform in California and ominous signs from Massachusetts spell big trouble ahead for reforming the nation's health care system no matter who is elected President. The lessons from those states, which have tried hard to bring insurance coverage to all residents, are worth heeding for anyone sitting in the White House next year. They also raise the question of whether it is possible, either fiscally or politically, for states to do the job. Indeed, failure in California and troubles in Massachusetts indicate that the underlying problems that bedeviled reform efforts fourteen years ago are still with us, and could doom yet another attempt to change the American way of health care.

Although Hillary Clinton and Barack Obama try to distinguish between their plans, both are variants of the Massachusetts model. That scheme requires everyone to get health coverage, and it imposes tax penalties on people who don't -- the so-called "individual mandate." In both Obama's and Clinton's plan, people do not have a right to health insurance, as is the case in truly universal national health insurance systems, such as in France and Canada, where everyone is guaranteed coverage, with care paid for through a broad-based tax. Instead, both candidates have used the word "universal" to describe a potpourri of options that could bring coverage to some portion of the population currently not covered while keeping commercial insurance in the game. Clinton's plan includes an individual mandate. Obama would require coverage only for children and touts cost-control measures that he says would lower premiums so much that the uninsured could afford them, obviating the need for a coercive mandate. Clinton would boost coverage by requiring large employers to cover their workers, giving incentives to smaller ones to do the same. Obama would make employers provide "meaningful" coverage or contribute to a public plan. Both proposals call for some sort of public alternative that people can buy into if they don't like the market choices, and both try to control medical costs with weak remedies like improved information technology and better care coordination.

Significantly, the premium subsidies and tax credits that Clinton, Obama, and John McCain support to help low-income families buy insurance are a traditional Republican strategy that President Bush has pushed for years. But at least 55 percent of the uninsured already pay no taxes, so unless the credit is made available to non-tax filers, this approach would leave lots of people without coverage. To be useful, subsidies must be high enough to help families pay the annual insurance premiums -- now averaging about $12,000 -- but low enough so the government doesn't go broke. And therein lies the devil that killed reform in California and could do in the much-hailed Massachusetts plan as well: the money just wasn't there.